Recent reports have postulated the existence of two different types of self
-injurious behavior: impulsive and compulsive. The aim of the present study
is to analyze the dimensionality of self-injurious behavior and to study t
he link between self-injurious behavior and clinical features in anorexia n
ervosa. The study involved 236 consecutive patients with anorexia nervosa,
diagnosed by DSM-IV criteria. Subjects were evaluated by means of a semistr
uctured interview and self-reported questionnaires, such as the Eating Diso
rders Inventory and Hopkins Symptom Checklist. A principal component analys
is was used to study the dimensionality of different types of self-injuriou
s behavior, including purging. Our findings confirm the distinction between
impulsive and compulsive self-injurious behavior. The dimensions appear to
be represented as a continuum in both the anorexia nervosa diagnostic subg
roups. A third distinct dimension emerged that; included self-induced vomit
ing and laxative/diuretics abuse. Childhood sexual abuse and anxiety signif
icantly predict the presence of impulsive self-injury, whereas obsessionali
ty and age predict compulsive self-injury. The coexistence of a positive sc
ore on both dimensions of self-injurious behavior was the strongest predict
or of treatment dropout. The present study highlights the importance of sel
f-injurious behavior; it should be given due consideration in future outcom
e studies on anorexia nervosa.